Kronik fiziksel özürlü bireylerde ağrı, depresyon, anksiyete ve fonksiyonel bağımsızlık ile yaşam kalitesi arasındaki ilişki

Amaç: Bu çalışma, kronik fiziksel özürlü bireylerde ağrı, depresyon, anksiyete ve fonksiyonel bağımsızlık ile yaşam kalitesi arasındaki ilişkiyi belirlemek amacıyla planlandı. Gereç ve Yöntem: Çalışmaya yaş ortalaması 38.18±11.06 yıl olan 82 sağlıklı birey ve 37.72±16.40 yıl olan 89 kronik fiziksel özürlü birey olmak üzere toplam 171 birey dahil edildi. Olguların yaş, boy, kilo, cinsiyet, eğitim düzeyi, meslek, medeni durum gibi fiziksel ve sosyal özellikleri kaydedildi. Ağrıyı değerlendirmek için Vizüel Analog Skalası, depresyon için Beck Depresyon Envanteri, anksiyete için Beck Anksiyete Envanteri, yaşam kalitesi için Nottingham Sağlık Profili, fonksiyonel durum için Fonksiyonel Bağımsızlık Ölçümü kullanıldı. Bulgular: Sağlıklı bireylerle karşılaştırıldığında kronik fiziksel özürlü bireylerde ağrı, depresyon, anksiyete değerlerinin daha yüksek, yaşam kalitesi değerinin ise daha düşük olduğu ve gruplar arası karşılaştırmada ağrı, anksiyete, depresyon, fonksiyonel bağımsızlık ve yaşam kalitesi arasında anlamlı bir farklılık olduğu bulundu (p

The relation between health-related quality of life and pain, depression, anxiety, and functional independence in persons with chronic physical disability

Objectives: This study was designed to investigate the relation between health- related quality of life and pain, depression, anxiety, and functional independence. Methods: The study included 82 healthy subjects aged 38.18±11.06 and 89 physically disabled subjects aged 37.72±16.40. Physical and social characteristics of the subjects such as age, height, length, weight, gender, occupational and marital status, and level of education were recorded. Visual Analogue Scale, Beck Depression Inventory, Beck Anxiety Inventory, Nottingham Health Profile, and Functional Independence Measure were used to evaluate pain, depression, anxiety, quality of life, and functional independence, respectively. Results: Compared to healthy individuals, chronically disabled subjects had higher pain, depression and anxiety and lower quality of life scores. Between-group comparison showed that there was a significant difference in pain, depression, anxiety levels and health-related quality of life (p<0.05). Similarly, both healthy and disabled individuals indicated a negative correlation between pain, depression, anxiety and quality of life (p<0.05). Conclusion: In individuals with chronic disabilities, pain may induce serious psychological problems, negatively affecting quality of life. This study showed that in chronically disabled individuals, there is a strong correlation between pain, depression, anxiety, and quality of life. These results should be considered carefully when planning assessment and rehabilitation programs for individuals with chronic disabilities.

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  • 1.Carod-Artal FJ, Trizotto DS, Coral LF, Moreira CM. Determinants of quality of life in Brazilian stroke survivors. J Neurol Sci 2009;284(1-2):63-8.
  • 2.Livingston MH, Rosenbaum PL, Russell DJ, Palisano RJ. Quality of life among adolescents with cerebral palsy: what does the literature tell us? Dev Med Child Neurol 2007;49(3):225-31.
  • 3.Bjornson KF, McLaughlin JF. The measurement of health-re lated quality of life (HRQL) in children with cerebral palsy. Eur J Neurol 2001;8 Suppl 5:183-93.
  • 4.Andrén E, Grimby G. Activity limitations in personal, domestic and vocational tasks: a study of adults with inborn and early acquired mobility disorders. Disabil Rehabil 2004;26(5):262-71.
  • 5.Padua L, Aprile I, Cavallaro T, Commodari I, Pareyson D, Quattrone A, et al. Relationship between clinical examination,quality of life, disability and depression in CMT patients: Italian multicenter study. Neurol Sci 2008;29(3):157-62.
  • 6.Grimby G, Andrén E, Holmgren E, Wright B, Linacre JM,Sundh V. Structure of a combination of Functional Independence Measure and Instrumental Activity Measure items in community-living persons: a study of individuals with cerebral palsy and spina bifida. Arch Phys Med Rehabil 1996;77(11):1109-14.
  • 7.Bergés IM, Ottenbacher KJ, Kuo YF, Smith PM, Smith D,Ostir GV. Satisfaction with quality of life poststroke: effect of sex differences in pain response. Arch Phys Med Rehabil 2007;88(4):413-7.
  • 8.Kong KH, Yang SY. Health-related quality of life among chronic stroke survivors attending a rehabilitation clinic. Singapore Med J 2006;47(3):213-8.
  • 9.Kranciukaite D, Rastenyte D. Measurement of quality of life in stroke patients. Medicina (Kaunas) 2006;42(9):709-16.
  • 10.Budh CN, Osteråker AL. Life satisfaction in individuals with a spinal cord injury and pain. Clin Rehabil 2007;21(1):89-96.
  • 11.Judd FK, Brown DJ, Burrows GD. Depression, disease and disability: application to patients with traumatic spinal cord injury. Paraplegia 1991;29(2):91-6.
  • 12.Elliott TR, Shewchuk R. Social support and leisure activities following severe physical disability: Testing the mediating effects of depression. Basic Appl Soc Psychol 1995;16:471-587.
  • 13.Nydevik I, Hulter Asberg K. Subjective dysfunction after stroke. A study with sickness impact profile. Scand J Prim Health Care 1991;9(4):271-5.
  • 14.Shimoda K, Robinson RG. The relationship between social impairment and recovery from stroke. Psychiatry 1998;61(2):101-11.
  • 15.Strine TW, Kroenke K, Dhingra S, Balluz LS, Gonzalez O, Berry JT, et al. The associations between depression, health-related quality of life, social support, life satisfaction, and disability in community-dwelling US adults. J Nerv Ment Dis 2009;197(1):61-4.
  • 16.Ku JH. Health-related quality of life in patients with spinal cord injury: review of the short form 36-health questionnaire survey. Yonsei Med J 2007;48(3):360-70.
  • 17.Altındağ Ö, Soran N, Demirkol A, Özkul MY. The association between functional status, health related quality of life and depression after stroke. Türk Fiz Tıp Rehab Derg 2008;54:89-91.
  • 18.Russo RN, Miller MD, Haan E, Cameron ID, Crotty M. Pain characteristics and their association with quality of life and self-concept in children with hemiplegic cerebral palsy identified from a population register. Clin J Pain 2008;24(4):335-42.
  • 19.Tyler EJ, Jensen MP, Engel JM, Schwartz L. The reliability and validity of pain interference measures in persons with cerebral palsy. Arch Phys Med Rehabil 2002;83(2):236-9.
  • 20.Hisli N. Beck Depresyon Envanteri’nin üniversite öğrencileri için geçerliği ve güvenirliği. Psikoloji Dergisi 1989;7:3-13.
  • 21.Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-71.
  • 22.Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric Proporties. J Cogn Psychotsher, Int Q 1998;12:163-72.
  • 23.De Ayala RJ, Vonderharr-Carlson DJ, Doyoung K. Assessing the Reliability of the Beck Anxiety Inventory Scores. Educ Psychol Meas 2005;65:742-58.
  • 24.Kücükdeveci AA, McKenna SP, Kutlay S, Gürsel Y, Whalley D,Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res 2000;23(1):31-8.
  • 25.Gokkaya NK, Aras MD, Cakci A. Health-related quality of life of Turkish stroke survivors. Int J Rehabil Res 2005;28(3):229-35.
  • 26.Ottenbacher KJ, Hsu Y, Granger CV, Fiedler RC. The reliability of the functional independence measure: a quantitative review.Arch Phys Med Rehabil 1996;77(12):1226-32.
  • 27.Küçükdeveci AA, Yavuzer G, Elhan AH, Sonel B, Tennant A.Adaptation of the Functional Independence Measure for use in Turkey. Clin Rehabil 2001;15(3):311-9.
  • 28.Ravenscroft A, Ahmed YS, Burnside IG. Chronic pain after SCI.A patient survey. Spinal Cord 2000;38(10):611-4.
  • 29.Worz R. Pain in depression-depression in pain. Pain Clinical Updates 2003;XI:1-4.
  • 30.Symreng I, Fishman S. Anxiety and pain. Pain Clinical Updates 2004;XII:1-6.
  • 31.Rickards H. Depression in neurological disorders: Parkinson’s disease, multiple sclerosis, and stroke. J Neurol Neurosurg Psychiatry 2005;76 Suppl 1:i48-52.
  • 32.Anderson CJ, Vogel LC, Chlan KM, Betz RR, McDonald CM.Depression in adults who sustained spinal cord injuries as children or adolescents. J Spinal Cord Med 2007;30 Suppl 1:S76-82.
  • 33.Kreuter M, Siösteen A, Erkholm B, Byström U, Brown DJ.Health and quality of life of persons with spinal cord lesion in Australia and Sweden. Spinal Cord 2005;43(2):123-9.
  • 34.Okoro CA, Strine TW, Balluz LS, Crews JE, Dhingra S, Berry JT,et al. Serious psychological distress among adults with and without disabilities. Int J Public Health 2009;54 Suppl 1:52-60.
  • 35.Carod-Artal FJ, Ziomkowski S, Mourão Mesquita H, Martínez- Martin P. Anxiety and depression: main determinants of health-related quality of life in Brazilian patients with Parkinson’s disease. Parkinsonism Relat Disord 2008;14(2):102-8.
  • 36.Kemp BJ, Krause JS. Depression and life satisfaction among people ageing with post-polio and spinal cord injury. Disabil Rehabil 1999;21(5-6):241-9.